Kicking Away Bursitis and Tendonitis Pain

May 9, 2016

Bursitis and tendinitis are conditions that cause swelling around muscles and bones.  Salonpas sat down with Dr. David Blackmer, a Boise, Idaho-based podiatrist and foot doctor, Blackmer Foot & Ankle to learn more about these conditions and how to keep our feet and ankles pain-free and healthy:

Dr. David Blackmer

Dr. David Blackmer

How do people get bursitis and tendonitis?  How do these conditions differ?

Most commonly, bursitis is a result of overuse and injury, although sometimes it can be caused by an infection as a result of gout or rheumatoid arthritis.

Tendonitis is generally caused by a repetitive action, where the tendons needed to make a certain movement over and over.  However, tendonitis’s can also be a result of injury, aging and certain diseases, such as diabetes or rheumatoid arthritis.  There is an increased risk for tendonitis for athletes who play certain sports requiring repetitive movement; such as tennis, golf, running, or baseball.

While bursitis and tendonitis’s have similar symptoms, they differ in the anatomy which they affect.

Tendons are thick cords that join your muscles to your bones. When these tendons become irritated or inflamed, it is called tendinitis. This condition causes acute pain and tenderness, making it difficult to move the affected joint.

Wherever your bones, tendons, and ligaments move against each other, particularly near joints, they cushioned by small fluid-filled sacs called bursa.  By reducing friction, the bursa helps the joints operate smoothly through the full range of natural movement. But when a bursa becomes irritated and swollen, it’s called bursitis — or inflammation of the bursa.

What body parts are most affected?

Any bursa can become affected, causing bursitis; however, the most common areas for bursitis are the shoulder, elbow, foot, heel, knee and hip.

PeripheralNeuropathyTendonitis can also occur almost anywhere that a tendon connects bone to muscle. However, the most common areas of tendonitis are the base of the thumb, elbow, shoulder, hip, knee and the Achilles tendon.

Is there a genetic component to be affected by these ailments?

As far as I am aware, there is no direct genetic component to either of these ailments, other than a genetic structural deformity.

How do you treat patients diagnosed with bursitis or tendinitis?

Generally, bursitis and tendonitis treatment usually involves conservative measures, such as rest, ice and taking a pain reliever.   More aggressive treatment of bursitis can include injections of a corticosteroid into the bursa to relieve inflammation.  This treatment usually brings immediate relief to the patient, and in most cases, one injection is all you would need.  Very rarely is surgery needed to remove a bursa unless it continues to reoccur after conservative treatment fails.  I also educate my patients about cross training with different activities to help prevent overuse injuries such as tendonitis and bursitis.

How is someone diagnosed with bursitis or tendinitis?

Typically, tendinitis is diagnosed by a physical exam alone. If the symptoms present as tendonitis, we can order an ultrasound or MRI scan to help determine the severity of damage to a tendon and to confirm the physical exam diagnosis.

Similarly, bursitis is diagnosed through a physical exam.  Diagnostic tests may be done to rule out other ailments that have symptoms which mirror bursitis.  An x-ray can rule out bone spurs or arthritis.  In order to rule out gout or infection, sometimes fluid is taken from the swollen bursa and examined.

Are there any exercises you recommend to help alleviate pain?

For bursitis patients, maintaining strength and flexibility at the point of the swollen bursa can help reduce the friction that causes the inflammation and pain.  Gentle stretching can decrease tightness in muscles and may alleviate pain.  Specifically for hip bursitis, there are specific exercises for the abductor and adductor muscles.

Muscles called abductors run along the outside of your thigh and your leg out to the side from your hip joint. These muscles can be stretched in a standing position by crossing the unaffected leg in front of the painful leg, then leaning away from the painful hip until a stretch is felt along the outside of the hip. Adductor muscles move your leg inward and can be stretched in multiple positions. Standing with the legs more than shoulder-width apart, the knee on the non-injured side is slowly bent out to the side until a stretch is felt on the inner thigh of the affected leg.  These exercises target muscles that move your leg at the hip joint. Stretches to help relieve hip bursitis are typically held for 20 to 30 seconds each and repeated several times per day.

With tendonitis, bending or straightening your joints can be painful and difficult. You can, however, use various exercises and stretches to help minimize pain while the tendon is healing.

Following are some suggested exercises to help alleviate tendonitis pain:

  1. Forearm stretch

The forearm stretch can help to relieve pain in your wrists and return flexibility to the tendons in your forearm. To perform this exercise sit or stand with your arm out in front of you. Your palm should be facing the floor. Grab onto your fingers with your other hand and gently pull them back until you feel a stretch in your forearm. Hold this position for several seconds and repeat on your other arm.

  1. Elbow Stretch

This stretch helps the tendons that attach to your elbow. To perform this exercise, place your palms together in front of you like you are praying. Your fingers should be right below your chin. While keeping your palms pressed together, lower both arms as far as you can without separating your palms.

  1. Calf Stretch

To relieve tendonitis in your legs, perform the calf stretch. This stretch helps to return flexibility to your calf and can relieve tendonitis in your ankles. To do this stretch, stand facing a wall. Put both hands on the wall and step back with one foot. Your heels should be flat. Bend forward with your front leg and feel the stretch in your calf. Hold for several seconds and repeat on your other leg.

  1. Quadriceps Stretch

The quadriceps stretch helps to return flexibility to the tendons attached to your knees and relieves patellar tendonitis. To perform this exercise, stand in front of a table or chair. Put one foot on the surface with the top of your foot down. Your knee should be facing the floor. Lean forward slightly to stretch the quadriceps of your back leg. Repeat on your other leg.

How important is it to go to a physical therapist?

A physical therapist can help establish an exercise plan for recovery for both tendonitis and bursitis.  Working with a physical therapist can be ideal, as it can ensure that the patient is using correct form, and therefore not at risk for causing further injury.  Your physical therapist can recommend a home-exercise program to strengthen and stretch the muscles around your shoulder, arm, chest, ankle and neck to help prevent future injury.

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